关键词: 冠状动脉分流术, 冠脉内膜剥脱术, 冠脉慢性完全闭塞

Abstract: [Abstract] Objective:   To study the application of coronary endarterectomy (CE) in coronary artery bypass graft(CABG) , and to evaluate the effect of CE plus CABG on patients with chronic total occlusion (CTO) combined with diffuse distal atherosclerosis．Methods:   Data from the 31 patients, who underwent coronary endarterectomy in our institution between October 2009 and October 2012, were reviewed retrospectively and compared with a control group of 31 patients matched for age, sex, LV function, and angina class. Results:   27 patients had one, four had two coronary arteries endarterectomized. Of these 35 endarterectomies, 13 (37%) the left anterior descending artery, 3(8%) branches of the circumflex artery, and 19(54%) involved the right coronary artery. There was no myocardial infarctions in the endarterectomy group and control group. All patients were followed up and no recurrent angina in the endarterectomy group. In CE group a patient died of fungal pneumonia and heart failure half a year after operation. Conclusion:   In current cardiac surgical practice, coronary endarterectomy is an indispensable adjunct to CABG. The operative mortality and major morbidity were comparable or similar to coronary artery bypass grafting, and short-term and medium-term results were favorable.

Key words: coronary artery bypass, coronary endarterectomy, chronic total occlusion of coronary artery